Tuesday, March 22, 2011

Here's the Bullseye... It's on My Back... Fire Away

Kevin MD has turned the internet medblog into a business (and damn him for being better at it than we are... uh,  I mean, congratulations, doctor). He is kind of the Drudge of Medical News. Recently he posted this, from a Child Psychiatrist, and it kinda struck a sour note on my first read, and on my second and third the sour note turned sour-er.... I'm going to stay out of the gutter on this one, but I do want to take issue with this physician's viewpoint.

Here's the statement that got me, and one that, no doubt, in today's post-modern society, didn't raise an eyebrow with many who, thirty years ago would have said, 'hmmm.'.

Doctors should be the most supportive of professions when it comes to our colleagues becoming parents. We work every day with patients in difficulty and know the importance of a strong family, and yet our profession is one that makes it very difficult to balance both a working and parental role. Part time work is difficult to manage, clinical meetings and ward rounds are often held very early or after hours, and the on call work can be brutal. But we are more than doctors; we are mums and dads and wives and husbands, and we shouldn’t have to pick one or the other. We can’t do it all, and maybe we should stop trying to.

We should be the most supportive profession when it comes to our colleagues becoming parents? Why. I'll stop there for a minute because I really want an answer to that. Why should we be? So as to model good parenting for our patients? Really, that's the reason?

Shouldn't have to pick one or the other??? Why? Because you want it all? Really, why?

Since when has becoming a physician been anything less than a dog-eat-dog marathon of sleep deprivation and ladder climbing, and patient care above all else? I'm not saying it should be that or that it has to be that, but what, doc, exactly, did you think you were signing up for when you walked into first year med? I mean, did you not know about the demands of the most demanding profession? Did you expect them to be lessened for you specifically?

And Dr. Baker, it's America and you can find your bliss however you want. And I'm glad you are putting your kids first... honestly I am. But you signed on to put your patient's first. Who is taking care of them now? Your partners? Is that a good thing for your patients? For your partners? Honestly? Is it?

And what of you female residents who get pregnant in residency. Is it fair to make your colleagues, male and female, make up for your three month absence with every other night call and missed vacations? Really? And did you have to make up that lost time or did the program simply graduate you 'as is'?

Let me take you back twenty years, before the walls of medicine began to crumble, back when the shortage of physicians was beginning to have an impact.
How much sense did it make back then, when planning for twenty years down the road, to offer not just equal opportunity to female applicants to medical school, but preferential admission to medical school? And how many of those female docs twenty years ago are practicing full time?

So what, you say? So why is no one talking about this as a cause of our current physician shortage? In the name of PC feel-goodism we essentially dropped the number of full time physicians by 33% by mandating a 50/50 male-female ratio. Hell, in many med schools women outnumber the men. It doesn't last...

In my class alone four of the female graduates got pregnant and didn't even go to internship. Fair? Maybe. Smart? No, not unless the women who desire to be doctors are made to understand, up front, that full time medicine/surgery and being a mom is not realistic in many of the medical subspecialties. It should be HARDER for women to get into medical school... not grade wise, but interview wise.... Women should be put on the spot in the interview process about their desire for a medical career and not just a medical degree.

So how about it Dr. Barker. How are your partners taking your two year absence? Your patients? I can see from what you write that their reactions have surprised you. But why are you surprised? There's a question.

And at the end of the day, I do honestly wish you all the success and happiness in the world for you and your kids and in your career. I just want to point out that in order for you to have things the way you want them, you have made others pay the price for a decision you made to become a doctor, perhaps without being honest about your desire to have a family or your ability to be both a great mom and a great doctor. 

50 comments:

  1. I have to say, I too snarled at 2 pregnant nursing students who weren't going to delay another baby for anybody. My college would have made them drop out if they wanted any more accommodation other than avoiding exposure to fetal-compromising disease, etc. I found that these two women didn't miss a beat and successfuly got the deed done during breaks. All were at that next 12 hour clinical without complaint, just a slight limp on the long walk through the parking lot... :)

    Thing is, some people are not so disrupted by it all. Some do pull it off. I know two specifically (Gensurg, OB-GYN) who, do it and have it all. Full of energy they are, and none of it appears to take much effort, the crazier the better.

    Of course, I am from the North, we are better in all things.

    -SCRN

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  2. Personally, I am 100% in favor of more women than men in medical school....especially blondes. Yea, blondes...

    -MS1

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  3. Hey 911, Just a thought. I had assumed you had a family or at least were maybe in a relationship. You have to admit that all MDs, just in the becoming and then being an MD make those around them suffer somewhere along the way. Not everybody can live without the family thing like you can, you have to see this, right? You see, the male MDs I know, most with families and small kids are "into" their lives outside work and are happy. Wives are medical or corporate too, they aren't stay at home mommies. Actually I'm not and never have been, and, I have no friends/aquaintences that are. I guess, it works out for most people who want both things in life. Takes some wrangling, but anything worth it, that you really want does. It's a team effort, or I don't play.

    -SCRN

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  4. Dear SCRN,
    No doubt, but there is no "I" in team, but for our friend the child shrink there does appear to be an "M" and an "E" and you better love it or else!

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  5. "Since when has becoming a physician been anything less than a dog-eat-dog marathon of sleep deprivation and ladder climbing, and patient care above all else?"

    Since at least 2001 when I started. It's just a job. Nothing more.

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  6. In nursing school we were told the only difference between the staff and the patients on a psych ward, was the staff wore name tags. The Child Psychiatrist just made that point.

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  7. 9-11, (6-7)Its like my Dad told me one time when my Sister got away with something I got my ass beat like Nicole Simpson for..
    "She'll get hers Frank, one day She'll have to (redacted)her boss to get ahead in this world, while you'll just have to kiss his Ass"

    Gotta take the other side here 6-7, I mean 9-11. My Med School Class was the first to have more Bee-Otches, I mean Chicks than Dicks,umm thats not quite true, than natural born males and NONE of em got pregnant during MedSchool/Residency.
    How could they? they were all Rug Munchers!!!!
    I mean they must have been, they wouldnt have sex with a Pimp like me, even the Ugly ones...
    And even if I had been home more, with all the Boarding School/Riding Lessons/Swim Team/Gymnastics/Softball/Tennis/Volleyball I still wouldnt see my kids more than a few hours a week, which is how I want it..
    I mean how they want it...

    Frank

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  8. Based on what you wrote, you might as well as have doctors take the vows of poverty and chastity, put the hair shirt on and renounce the ways of the world.
    Perhaps more of emphasis on an outside life would keep docs from becoming jaded and bitter.
    And it is hypocritical for a profession that professes to "care" not to extend that to their colleauges.
    I once worked with a surgeon who operated the day after his son committed sucide. People applauded him. I thought no wonder the poor kid did himself in.

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  9. Anon.,
    Nice try. I do not applaud that surgeon and he is a freak, but Mesicine used to be a calling and my point is that it serves it's purpose of doing the most good for the most people when it remains a calling and not "just another job".

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  10. Anonymous, if that really is your name.
    Eff You, OK, if you can read with a (redacted) in your (redacted) follow me..
    Most of us went into medicine cause we WERE poor, infact I was so poor, I couldn't pay attention. Or my light bill, water bill, rent, And I chose my Med School cause it was on the border with 2 states, so you could sell Plasma 3 times/week, 6 if you had a good fake ID...
    And I'm callin BS on the "Surgeon who operated the day after his son committed suicide" story, although I wouldn't blame him if it really happened.
    Suicides for pussies unless you got the Red Army bustin down your bunker, even then you should go down shootin...
    And unlike 9-11, I like more Vaginas in Medicine, just more overtime for Me..

    Frank

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  11. Frank, I don't really belive you're that mean and no BS on the suicide story.
    Of course it's a calling and requires a lot of sacrifice.
    But this topic is worth a REASONABLE discussion. Maybe taking two years off to be with your baby is extreme.
    But let's expand this conversation and say you had a child or a spouse with a life threatening disease. Who then becomes your priority?
    Your comment about being a mom is not compatible in many med subspecialities spould be gender neutral unless you're a Neanderthal who thinks dads play no part in their child rearing.

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  12. OK annonymous, I'm mean, its hereditary, my Dad dropped Napalm on Vietnamese, his Dad dropped Napalm on Japanese, and HIS Dad was a Sissy so he just set po' Black Familie's houses on fire with old fashioned diesel fuel...
    I'm actually the Nice Guy in the Drackman Klan, buttt..........
    You know how many extra calls/shifts me and 6-7(9-11)have had to pull cause XX some XX of XX our XX classmates XX colleagues XX have sick Kids/Nasty Snatch/PMS/kids just killed himself bla bla bla...
    I mean sometimes my sexual organs hurt to, but I don't take a Sick Day, I still show up just like Lou Gehrig did till he got Lou Gehrig's Disease and died, the big Sissy...
    If I'm gonna be sick, I want EVERYONE to be sick too..
    And Neanderthals actually had bigger brains than Homos Sapiens.

    Frank

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  13. dear Anon.,
    there was this mom in SC once who drowned both her kids in the back of a station wagon then blamed it on black people. this means all moms are horrible and that mom-hood is nothing special and just another job.

    but 'gender-neutral'... hahaha..... hahahahahaha.... bwaaaaahahahaaaahaaaaaa.... 'gender neutral'..... unicorns, free money, 'it's just sex', and OJ is zeroing in on the real killer. HAAHAHAAHAHA.... you slay me.

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  14. In nursing, often the "males" were just POA. The fuggly ones too. Which is why they could screw it all up, and that was OK. FYI.

    Sounds like you think that if a female MD has a kid, she needs to buy herself a house husband if she plans to work. If a male MD wants a family, he needs to buy a wife if he wants to work?! Your thoughts? Seems often both feel others need to see them as special beings, which, is sad because nobody really does unless you can bring home the serious big bucks and stuff...

    -SCRN

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  15. Not saying that at all... Simply saying that if you want to be an MD and you also want to be a mom then think about what you are doing. Make a choice. Don't seek to bring down the profession to assuage your hurt feelings when your ankle-biters come along and you want time off.

    Twenty years ago I wanted to fly jets in the Air Force... Got accepted too... Also got accepted to medical school... I made a choice... In retrospect a really stupid one because I thought medicine was unique and special when it turns out it's "just a job"... Plus, if I was flying A10s then I would at least have an outlet for my anger and would gladly accept the downside (people trying to kill me with guns), to be part of an elite team.

    Oh, and just got some good news about my dad... Just got an emergent 4x bypass... The surgeon who saved his life came out and shook my hand and did the incision to close in three hours... He's actually nothing special... He just does a job. Just like waxing floors.

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  16. Oh, I don't know 911. Those truely at the razor's edge are few. Lots of wannabes but really very few people would qualify to get a papercut there, now and in years past. Always been that way. But I understand wanting to feel part of that. When people aren't married to it anymore, the whole thing does change. But I'd say universally it is the same with all things these days. I understand where you're coming from in that. I don't think it's just girl docs - that's just what set you off this time. It's an entire system change, been going on for quite some time. Sucks to feel devalued.

    -SCRN

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  17. So the bottom line is female + medical career = no kids because being a doctor will always trump being a mommy.
    Yu must have trained with some real losers....all the female residents and interns I've seen are dilated at least 3 cm before they finally (gasp) take the time to have the baby. I guess you want them to just squat down and plop them on the floor in the doctor's lounge and get back to the bedside.
    Personally with all the burnout I see with physicians...both xx's and yy's (good one frank :)) maybe all docs should take an extended LOA occassionally just to restore their sanity.
    PS. Frank, freudian slip on the Homos part of what is actually Homo Sapiens?

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  18. Six women in my medical school class. Four flunked the first year..Only 3 graduated..Nuff said, OF

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  19. I love this discussion. I actually have several classmates who would like to have kids. I feel somewhat bad for them, but then I remind myself that they did make the choice to go to med school.

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  20. OF you are just crabby (but cute).

    Anon 1:03, Frank is a freudian slip, in many ways. How observant.

    -SCRN

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  21. Anon.,
    no. wrong. not what it said. happen to be married to a physician. she chose one specialty over her 'true love' because she wanted to have a family. know many women who go the PA route because they want to make family their first priority. that's what i'm saying. make a decision, be realistic, you can not, in fact, have it all unless you force others to take up your slack.

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  22. 9-11(6-7), you had a chance to fly Air Force Fighters and you chose THIS?!?!?! WERE YOU INSANE?!?!? Oh yeah, they weren't takin Homos in 1991, my bad...
    If it wasn't for my Astigmatism just a diopter away from needing the Hubble to see my Crank, I'd have been a "Goose" riding Mavericks Tail to fight the Migs, those fighter pilots have it rough, fly maybe 8 hrs a week, spend the rest of the time hittin the gym, bangin broads, sleepin off hangovers, I mean getting "Crew Rest" for that grueling 2hr Cross Country flight to Panama City...
    and Military pilots are already out flyin with Delta or United pushin buttons on a 757 before you'd even be out of residency...
    and how many "Airline Pilots OD" blogs are there with grouchy pilots complaining about those grueling EIGHTY HOUR WORK SCHEDULES...
    Ummm thats 80 hours a MONTH...

    Old Fart, was Hippocrates really all that smart????

    Frank

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  23. Where ya think the term "hippy" came from chump..
    I've got an airline pilot buddy..Geez the dude "bids" for days to work, as in: "uhh yeh I think I'd like to fly there...cain't do, oh well see me next month" He's got a hot stew for a wife..Seriously works 8hrs at a time, then somebody else has to fly the plane and he goes into his bunk and gets a bj from a stewardess or shines his own knob and eats sushi in Singapore when he lands...effin I want to be him when I grow up!! OF

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  24. I spent more than a few times in the back of an F-18...left my stomach there, too.

    Just got off the phone with my buddy...he's an NFO..(read: Goose), he told me that they're pulling second-tour pilots out of the community, handing them a joystick, and teaching them their new craft of flying predators, raining firey hell on targets from a trailer in the middle of missouri. Ill take medicine any day...even if its just reading Dubin's at this point.

    Some people are going to treat it like a job, some like an inescapable all-consuming beast. I'm shooting for somewhere in the middle, myself..

    --MS1

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  25. http://msn.careerbuilder.com/Article/MSN-2536-Job-Info-and-Trends-Well-paying-jobs-you-can-get-right-out-of-high-school/?SiteId=cbmsnhp42536&sc_extcmp=JS_2536_home1&gt1=23000
    Thought I'd end this debate with this tidbit. And to think you followed your calling :)

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  26. "Some people are going to treat it like a job, some like an inescapable all-consuming beast. I'm shooting for somewhere in the middle, myself.." --MS1

    Sigh, our little MS1 (sniff) so grown up!

    -SCRN

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  27. 911, Drackman, OF

    EM is getting pretty popular for its shift work without need for taking call. Do you do anything EM-related outside of your regular hours? (I'm assuming that Drackman is the Medical Director of some strip club somewhere...)

    -MS1

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  28. Medical Director of a strip club??

    I'm suddenly jealous of Drackman. Need to go commit suicide now.

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  29. Ok, I guess you're right, we shouldn't let women into med school (or make it impossibly hard/let only nuns in) because they MIGHT get pregnant and MIGHT drop out/take time off/go part time.

    By the same logic, we should put all black people in jail because they MIGHT mug someone. I'll phone the president and let him know.

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  30. Dear "scrivener" ,
    If you take your name from you actual profession that's cool... Don't quit your day job... But you work for a fucking idiot.

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  31. http://www.youtube.com/watch?v=Jdynfjcf_xM&feature=related

    -SCRN

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  32. Hey SCRN,
    How did you get that ancient video of me? Awesome.

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  33. 9-11's just jealous he's not a Bee-Otch and can't get pregnant and take a year off every other year, or a week off every month for his PMS, or show up late/leave early cause his kids got the runs...

    Frank

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  34. dear Frank, re USAF fighters... yeah, i know... but i did still get to get that pointy nosed experience and it was a blast but i didn't think at any point in that time, 'wow, i should have done this'.... preferred being their doc, not driving the things. and to be fair, the USAF was ready to take me in spite of the home thing because i didn't qualify as 'flaming' and i assured them that i didn't inhale.

    as for needing the hubble to see your crank, it's not your astigmatism... just sayin'...

    and most of my pilot buddies are out of work, so all in all, maybe it's a wash.

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  35. Y'know, this could be the nexus post for a good 'ole flame war with the mommy MD blog. Hoo, wouldn't want to bet on that one either way.

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  36. 9-11, glad you found a profession that makes you so happy & Cheerful...:)
    lookin at dudes cranks...
    seriously, nice thing about medicine is you can do it till your 90, like Old Fart, I mean Red Duke, did you know he was at Parkland when they rolled JFK in???
    Red Duke I mean...Old Fart was on the Grassy Nole...
    Pilots have it tough, you know how long my Dad looked for a job droppin Napalm on Vietnamese???

    Frank

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  37. Frank,
    what's a 'grassy nole'... is that a pothead from FSU?

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  38. My DNA was NEVER found on Grassy Nole...Not on any of the Nole girls...

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  39. I was looking seriously at PA school...I could get in too. But I am not going to because my kids are so young and they need me more than I desire to have a career in medicine. It would take the next 3 years of my life almost completely.

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  40. My Lovely Amy...
    2 Words:
    Bosnian Au'Pair(s) OK, thats 3 words...
    They work hard, like Americans did 100 years ago, and if you get one early enough your kids will get that haughty/sexy Bosnian accent for no extra charge...
    but as a compromise, if you dont mind working with a bunch of lesbians, you could go the RN-CRNA route, which is what I would have done if I wasn't hung like a Horse, cause even if he's John Holmes/Wilt Chamberlain/Bill Clinton combined into one 19foot tall Sex Machine, everyone thinks Male RNs are Homos...

    Frank

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  41. amy,
    then go after three years.... but God bless you for making a tough decision.

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  42. Amy, just keep your eyes and ears open though, everybody and their dog is going to PA school now. Be sure to reassess after those 3 years have passed!

    -SCRN

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  43. If some interviewer grilling me in 1996 had asked if I intended to have kids, let my husband's career dictate my location, etc. etc. I would've given all the "wrong" answers. Here we are 15 years later and none of that turned out to be true. Instead I've spent dozens of weeks on call covering for new fathers (there aren't enough women in my industry for me to have direct peers who are new mothers, ever), and seen plenty of sunrises at the tail end of 20+ hour days. I've worked through vacations, holidays, and doctor-mandated bed rest. But thank goodness the medical profession has been saved from accommodating my ambivalent, undedicated, female self.

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  44. Kipper,
    I'm so curious now... What job do you do? Do you have kids? And what country do you live in (I'm guessing Amazonia).

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  45. 911, you are an ass.

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  46. Dear anonymous,
    Yes indeed, and I may remain one. But you will always be an anonymous cowardly troll.

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  47. Frank! Since when did I become your "lovely Amy?" I'm almost touched.

    Thanks 911. I do feel like my brain is being wasted, and that's kind of what my professors are telling me too. But like you said, in a few years the kids will be older...maybe I'll get remarried and find me a house husband ;-) and then I can go onto my career. As of now, I'll make a kick-ass medical secretary type or something since I have all this medical knowledge that is just going to go to waste...

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  48. wat nonsense!!...dnt v...d women tak up d burden of providin dis world a new generation...cnt u share d work of ur female colleague fr a li l while??...u thnk v lik takin a break frm our careers??..dnt u get it??...it gives our careers als a huge downfall..tht career fr wich v hv worked as hard as u..to put it aside n think for d future happiness of d entire family is much much more difficult than jus doing sme extra work coz a female resident hs bcome pregnant...so stop cribbing n put ur asses to work...coz had it not been fr our sacrifices u wudnt b born right nw..

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  49. deer ann/// toobil lie-gay-shun// STAT!

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